They associate the number of caesarean sections to the difference in clinical practices between communities

The total average number of deliveries performed by caesarean section in Spain in 2020 was 24.23%, a figure almost ten points above the 15% recommended by the World Health Organization (WHO), warns the Health Circle that points to the difference in clinical practices between the autonomous communities as one of the causes.

In the case of caesarean sections performed in the National Health System (SNS), the figure improves to 21.81%. This is some of the data that is extracted from the new evaluative article of the indicators of the situation of the SNS carried out by the Círculo de la Sanidad, as a result of the information offered by the Ministry of Health and broken down and analyzed in the Observatorio de la Health, a platform launched by the entity to collect and analyze the main data on the situation of the system and its operation, collects EP

Thus, based on the data provided by the autonomous communities (INCLASS), it is possible to analyze the variability of the health indicators between the different regions and the different health services, figures that reflect the inequality of care results between the different areas geography and its causes.

In this sense, the variability in the practice of caesarean sections in the SNS between communities is striking, ranging from 13.92% in the Basque Country to 31.07% in Extremadura. Among the best rates, in addition to the Basque Country, there would also be Navarra, with 14.63% and the Canary Islands, with 16.73%. On the opposite side, the worst data would be recorded by Extremadura, Melilla and Castilla La Mancha with 31.07%, 28.85% and 25.07%, respectively.

According to the specialist in strategic health consulting, Luis Rosado, in charge of analyzing the data from the ‘Health Observatory’, among the possible causes of this variability “would be the difference in clinical practices between the regions, where, for example, they use techniques such as laparoscopic hysterectomy, or accessibility, relative to the delay both in gynecology consultations and in surgery».

Thus, Rosado underlines that there is “a better correlation between the membership indicator, which may express that the areas with the best caesarean section rate have a more advanced use of resources, assuming that the practice of laparoscopic surgery offers higher quality.”

The article also refers to the rate of caesarean sections including in the sum those that are carried out in the private sector and by autonomous communities; data slightly above those recorded in the SNS in all communities, except in Melilla, where the rate remains at the same level.

Thus, among the communities with the greatest difference would be the Canary Islands, the Balearic Islands, Andalusia or Madrid, with a difference of between three and four points in all cases. “This difference between the global data and those that come out only from the SNS can be interpreted as one of the consequences of meeting the expectations of patients in the private sector,” Rosado clarifies.